Nevirapine’s metabolism involves the cytochrome P450 enzyme system, specifically CYP3A4. Therefore, co-administration with medications metabolized by or affecting this enzyme warrants careful monitoring.
Rifampicin, a potent CYP3A4 inducer, significantly decreases nevirapine levels, potentially reducing its antiviral efficacy. Closely monitor viral load and consider dosage adjustments if co-administered.
Conversely, Protease inhibitors, such as ritonavir and lopinavir/ritonavir, inhibit CYP3A4. This interaction may increase nevirapine blood levels, raising the risk of hepatotoxicity. Regular liver function tests are necessary. Dosage reduction of nevirapine might be required.
St. John’s Wort, a herbal remedy, also induces CYP3A4. Avoid concurrent use due to potential nevirapine level reduction and treatment failure.
Antacids can slightly reduce nevirapine absorption. Administer nevirapine at least two hours apart from antacid intake.
The potential for interactions extends to other medications. Always consult a healthcare professional before combining nevirapine with other drugs to minimize adverse effects and ensure optimal treatment.
